J Korean Ophthalmol Soc.  2021 Oct;62(10):1435-1439. 10.3341/jkos.2021.62.10.1435.

Exophiala Endophthalmitis after Cataract Surgery

• Kim TH
• Shin MK
• Kwon YH

• KMID: 2521647
• DOI: http://doi.org/10.3341/jkos.2021.62.10.1435

Abstract

Purpose
To report a case of Exophiala endophthalmitis after cataract surgery, which has not been reported previously in Korea.
Case summary
A 70-year-old woman visited the hospital 7 days after cataract surgery in her right eye with unilateral vision impairment. At the time of the visit, visual acuity of the right eye was hand motion, and the fundus was not clearly observed due to numerous inflammatory cells with hypopyon in the anterior chamber. With an initial diagnosis of suspected bacterial endophthalmitis, vitrectomy was performed immediately with intravitreal injection of antibiotics and steroid. On day 14 after vitrectomy, inflammation in the anterior chamber and vitreous opacity worsened, and complete vitrectomy, including of the vitreous base, and removal of the intraocular lens and capsule was performed. Exophiala was detected in the biopsy specimen on day 6 after the second surgery, and the patient was discharged with a prescription for voriconazole eye drops. On day 23 after the second surgery, the best-corrected visual acuity in the right eye had improved to 1.0, and there was no evidence of endophthalmitis recurrence and no observed additional abnormal findings of the fundus until 6 months after second surgery.
Conclusions
In a case of fungal endophthalmitis that occurred after cataract surgery, good results were obtained by vitrectomy involving complete removal of the peripheral vitreous body, including the intraocular lens and lens capsule, which was the basis for growth of the fungus in the early stage of endophthalmitis.

Keyword

Cataract surgery, Endophthalmitis, Exophiala, Fungal ocular infection